In recognition of the burden of disease and mortality associated with substance use disorders, the Veterans Health Administration designated enhancement funds in the early 1990s to establish the VA Puget Sound Healthcare System Center of Excellence in Substance Addiction Treatment and Education (CESATE). The CESATE serves as a national resource, with a mission of improving the quality, clinical outcomes and cost-effectiveness of health care for Veterans with substance use disorders. Since its inception, the Seattle CESATE’s service goals have been to 1) develop, implement, evaluate, and disseminate best clinical practices and educational initiatives along the continuum of care for substance use disorders, 2) provide education and training in treatment of substance use disorders, 3) provide consultation and technical assistance to program managers, medical center leadership and VA Central Office on issues relevant to quality care of Veterans with substance use disorders, and 4) conduct clinical, health services, and educational research to improve the health of Veterans with substance use disorders. Additionally, we remain alert to national trends in substance misuse, gaps in healthcare services, as well as new treatments and VA priorities.
Since the early 1990’s the CESATE has been home to the Interprofessional Fellowship in Substance Addiction Treatment, a specialized clinical fellowship in the interprofessional team approach to substance use disorder treatment. Through a combination of intensive clinical training within the VA Puget Sound Addiction Treatment Center, developing knowledge and skills in program development, program evaluation, and/or clinical and health services research, and interprofessional didactic experiences, fellows from up to three clinical disciplines develop advanced skills in working therapeutically with Veterans with substance use disorders, become more familiar with the unique contributions that their professional disciplines make to treatment, and become better able to integrate these professional contributions in an interprofessional treatment process. Fellowship positions are full-time, typically one year in length, and available for disciplines including Psychology, Social Work, and Chaplaincy. To promote training in program development or clinical or health services research, a second-year fellowship is available for qualified candidates.
Goals of Interprofessional Fellowship
Our primary goal is to provide fellows with an excellent training experience in the interprofessional assessment and treatment of those with substance use disorders – one that will prepare them to assume clinical, academic, and/or administrative leadership positions in substance use disorder treatment within the Department of Veterans Affairs, in Academic Medical Centers, and in the community. The goals and objectives of the Interprofessional Fellowship program are common across disciplines, providing fellows with learning experiences deemed essential for all professionals working in addictive behaviors. The curriculum provides a range of structured clinical and didactic activities that allow individualized training, using individualized learning plans, to meet more specialized, discipline-specific goals and interests of fellows. A secondary goal is to increase knowledge and advance skills in program development, program evaluation, and/or clinical and health services research relevant to Veterans with substance use disorders.
Fellows can expect to develop advanced levels of knowledge and skills in assessment and intervention, quality improvement, clinical research strategies, and administration. Moreover, they can expect continued professional development, including further consolidation of professional identity, increased confidence in assuming an advanced level of professional responsibility, and advanced knowledge and skills in ethics, professional and legal standards, and in culturally competent practice.
Clinical Fellowship, Psychology Fellowship
Clinical training during the fellowship year takes place within the VA Puget Sound Addiction Treatment Center. The Addictions Treatment Center offers rehabilitation services and maintains a commitment to the continuity of care for Veterans with substance use disorders. Services provided include triage, assessment, referral, psychotherapy and psychiatry services, including but not limited to an intensive outpatient program, a mild to moderate co-occurring disorders program, a moderate to severe co-occurring disorders program, opiate replacement treatments, monitored Antabuse, monitored naltrexone, and continuing care. Specialized services for women are also available in a gender-sensitive environment.
As members of the interprofessional treatment teams, fellows contribute to the treatment process in multiple ways. Fellows may be involved in the initial screening and evaluation of potential patients, participate in the intake assessments of Veterans entering treatment, be involved in case conceptualization through participation in interprofessional treatment planning meetings, serve as individual case managers and therapists, co-lead therapy groups, monitor progress toward the attainment of the treatment goals established for each patient, work collaboratively with clients to develop discharge and disposition plans, and serve as co-therapists in the aftercare program.
Research & Academic Experiences
In addition to intensive clinical training, fellows will initiate and complete a quality improvement and/or a clinical research project, individually developed with supervision and consultation from the Fellowship Director, Addiction Treatment Center staff and supervisors, as well as faculty within CESATE.
Fellows attend a nine-month weekly seminar. The seminar includes academic readings each week and covers topics of diagnosis, etiology, epidemiology, natural history, change, treatment models, treatment outcome, relapse, individual differences and cultural factors, and special populations.
All Applicants must be US citizens.
Applicants for postdoctoral psychology fellowships at the VA Puget Sound Healthcare System, Seattle Division must be graduates of APA accredited doctoral programs and internships.